Miner Memorial Library
AV PREVIEW-FIRM ORDER FORM
AV INFORMATION
Title of DVD: ____________________________________________________
Item/Catalog Number: ____________________________________________
Vendor: (attach a copy of catalog page, if possible)
________________________________________________________________
Price: ________________ Shipping*: ________________
*If previewed DVD is returned, the shipping cost will not be credited to the invoice. .
FACULTY INFORMATION
Faculty name: ___________________________________________________
Faculty email or extension: ________________________________________
Course name(s): _________________________________________________
________________________________________________________________
________________________________________________________________
Classroom or online course: _______________________________________
Approximate number of students to view DVD: _______________________
Number of intended uses per semester/year: _________________________
**Do not order a DVD for preview
if preview is available to watch online.**
RECOMMENDATION FOR PURCHASE
Faculty Requestor: _______________________________YES_____ NO____
If “no”, reason: __________________________________________________
Division Chairperson**: ___________________________YES_____ NO____
**required for purchase
AV Purchasing Procedures and Preview/Firm Order Form (09/13)